ROLE OF SMARTPHONE OVERUSE AND DIGITAL POSTURE RESULTING IN FORWARD HEAD POSTURE LEADING TO TEMPOROMANDIBULAR JOINT DYSFUNCTION IN ADULTS: A PHYSIOTHERAPY INTERVENTION STUDY

Background: The temporomandibular joint (TMJ) is essential for chewing, speaking, yawning, and swallowing. With the growing dependency on smartphones, prolonged neck flexion and forward head posture (FHP) resulting from device use have emerged as modifiable contrib utors to temporomandibular disorders (TMD). Smartphones do not directly damage the TMJ; rather, sustained postural adaptations alter mandibular kinematics, overload masticatory and cervical muscles, and increase the risk of retrodiscal compression and disc displacement, resulting in pain and functional limitation. Aim: To investigate the impact of smartphone overuse and digital posture on temporomandibular dysfunction in adults and to evaluate the effectiveness of a posturefocused physiotherapy intervention. Methods: In this randomized controlled trial, 120 adults aged 40–65 years with mild– moderate TMD and habitual smartphone use (≥4 hours/day) were randomized to receive either conventional TMJ physiotherapy or the same program augmented with posture correction exercises. Primary and secondary outcomes included pain (Visual Analogue Scale, VAS), mouth opening (interincisal distance), mandibular function (MFIQ), and cervical posture (craniovertebral angle). Assessments occurred at baseline, 4 weeks, and 8 weeks. Results: Both groups improved, but the posture-focused group achieved greater gains (pain reduction 4.2 vs 2.7 points on VAS; jaw opening gain 7.8 vs 4.1 mm; MFIQ improvement −16.5 vs −9.2; CVA gain +6.2° vs +2.1°; p < 0.05). Typical symptoms at baseline included jaw pain, clicking/popping, restricted opening, morning headache, ear fullness/tinnitus, and neck/shoulder tightness. Improvements in cervical alignment correlated with symptom relief, supporting a mechanistic link between digital posture and TMJ dysfunction. Conclusion: Smartphone overuse promotes forward head posture and neuromuscular adaptations that contribute to TMD. A posture-focused physiotherapy program added to conventional TMJ care is more effective than jaw exercises alone. Integrating posture retraining into TMD management and public health ergonomics programs is recommended. Keywords: Temporomandibular joint dysfunction, smartphone overuse, digital posture forward head posture, physiotherapy, mandibular function